MS and Changes to Thinking and Memory

  • MSNZ
  • MS and Changes to Thinking and Memory

MS can sometimes affect how people think and remember. This is often described as “brain fog” — difficulties with concentration, word-finding, or remembering names. Around half of people with MS will notice these changes at some stage, but for most they are mild, temporary, and manageable. Cognitive changes can feel worrying, but they do not mean dementia or a loss of intelligence. With awareness and the right strategies, most people continue to manage well in daily life.

Common Concerns

  • Difficulty concentrating or keeping up in conversations
  • Forgetting things without reminders or notes
  • Struggling to plan ahead or solve problems
  • Slower thinking or processing of information
  • Trouble finding the right words when speaking
  • Feeling mentally fatigued, especially when tired or stressed

Things to Note

  • MS does not cause dementia — memory issues in MS are usually about retrieval, not storage.
  • Intelligence remains stable, even if thinking feels slower.
  • Cognitive changes can happen at any stage of MS, regardless of physical disability.
  • Fatigue, stress, depression, or medications can worsen “brain fog.”
  • Early recognition and support from family and friends makes a big difference.
  • Professional assessments by neuropsychologists, occupational therapists, or speech and language therapists can provide tailored strategies.

Practical Tips

  • Use a diary, organiser app, or reminders for appointments and tasks.
  • Keep a consistent routine (e.g., always leave keys in the same place).
  • Prioritise tasks and focus on one at a time.
  • Use mental imagery to support memory (e.g., linking names with visual cues).
  • Ask people to write down instructions or repeat them slowly.
  • Plan demanding tasks for times of day when you have more energy.
  • Puzzles, reading, and brain games can help keep your mind active.
  • Exercise can boost memory, mood, and problem-solving.

What's Next?

Changes to thinking and memory are common in MS, but they do not define you. By seeking support, using practical strategies, and working with your GP or neurologist, you can continue to live well.

If you notice ongoing changes, speak with your MS nurse, GP, or neurologist. They can suggest assessments, treatment options, and support services tailored to your needs.

Medical History & Neurological Examination:Medical History & Neurological Examination

The doctor collects a detailed history of symptoms, family background, and other relevant factors. A neurological exam assesses mental, emotional, and language functions, movement, coordination, balance, vision, and other senses. Keeping a record of symptoms and sharing them with your GP and neurologist is recommended for a comprehensive assessment

MRI scans are the most effective imaging tool for detecting MS plaques or lesions in the brain and spinal cord. They help identify both old and new areas of damage, but a diagnosis cannot be made based on MRI alone, as similar lesions can occur in other conditions or even in healthy individuals

These tests measure the nervous system’s electrical response to sensory stimulation (such as visual or auditory). They can reveal areas of slowed nerve conduction caused by demyelination, even when not detected in a standard exam

Analysis of cerebrospinal fluid can detect immune proteins and oligoclonal bands, which indicate inflammation in the central nervous system.

These findings support an MS diagnosis but are not exclusive to MS

While there’s no blood test for MS itself, blood tests are used to exclude other conditions that can mimic MS symptoms, such as infections or autoimmune diseases

Diagnostic Criteria

The internationally recognised McDonald Criteria (most recently revised in 2017) guide the diagnosis of MS.

To confirm MS, a doctor must find evidence of inflammatory damage in at least two separate areas of the central nervous system (CNS), occurring at different times, and rule out other possible diagnoses. The criteria allow for earlier diagnosis, even after a single clinical attack (Clinically Isolated Syndrome, or CIS), if MRI or other tests show additional evidence of disease.

Types of MS

MS can present in several forms, each with distinct patterns of symptoms and progression:

Clinically Isolated Syndrome

A first episode of neurological symptoms caused by inflammation or demyelination in the CNS, lasting at least 24 hours. CIS may or may not progress to MS, depending on MRI findings.

Relapsing Remitting MS

The most common type, marked by clearly defined relapses (attacks) followed by periods of full or partial recovery (remission). About 85% of people with MS are initially diagnosed with RRMS.

Secondary Progressive MS

Initially begins as RRMS, but over time, the disease transitions to a progressive course with or without occasional relapses, minor remissions, or plateaus.

Primary Progressive MS

Characterised by steadily worsening neurological function from the onset, without early relapses or remissions. About 10–15% of people with MS have PPMS.

Progressive Relapsing MS

A rare form featuring steady progression from the start, with occasional acute relapses.

Symptom Management